A Book Summary for 'A 'Case of Need'' by Michael Crichton

by James Rutter
Crichton's novel examines whether physicians should prevent harm by performing illegal procedures.

Crichton's novel examines whether physicians should prevent harm by performing illegal procedures.

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Novelist Michael Crichton first published his "A Case of Need" in 1968 under the pen name Jeffery Hudson. The novel concerns a Boston pathologist in the 1960s who becomes embroiled in an abortion scandal that led to the death of a young, pregnant socialite. Crichton weaves medical procedures and ethics into the legal and social milieu of America before the Supreme Court case "Roe v. Wade" legalized abortion.


Crichton wrote "A Case of Need" from the point of view of his protagonist, the pathologist John Berry. Berry's friend and fellow doctor Arthur Lee is a Chinese obstetrician accused of performing a then-illegal abortion on Karen Randall. Berry knows about Lee's illegal activities and has helped Lee cover up illegal abortions in the past. Karen's uncle Peter and father J.D. both work as physicians and are prominent members of Boston society. Both attempt to intervene in the case, and Berry later learns that Karen's uncle Peter had already performed two abortions on Karen. An African-American lawyer, George Wilson, assists Berry with his investigation to clear Dr. Lee.


Crichton set "A Case of Need" as a mystery story with elements of political intrigue, medical practice and legal and social issues. After listening to the rants of one of his associates, Berry receives a phone call from his wife, who informs him that the police have arrested Lee for the illegal abortion and subsequent death of Karen. Berry meets with Lee and agrees to help clear his name. His investigation brings him into contact with Boston society and a criminal underworld. Ultimately his training in pathology reveals that Karen was not even pregnant and his investigation, aided by Wilson, uncovers that a drug dealer performed the abortion.

Abortion Theme

Crichton's novel concerns abortion at a time when it was illegal except in rare cases. This issue divided moral and political thought in the 1960s of the book just as it divides many in America today. Although the novel opens by quoting the Hippocratic Oath, which commands to "first, do no harm," both Berry and Lee present compelling reasons for performing abortions, even illegal ones. Lee relates a tale of a desperate woman who asked for an abortion and then turned to a back-alley abortionist when he declined to perform the procedure. By following his oath, he had driven this pregnant woman to seek out a dangerous, unskilled practitioner.

Medical Ethics Theme

Crichton published this novel while still attending Harvard Medical School, and the book contains several episodes related to the practice of medicine. The novel opens on a scene where one of Berry's fellow doctors loses a patient during surgery. Instead of feeling depressed, this doctor throws a tantrum, which Berry shrugs at, realizing that doctors must find a way to deal with tragedy. Berry himself takes a cynical approach to the practice of medicine, viewing results as better than intentions. He participates in Lee's illegal abortions by helping him fake tissue samples that show that his patients were not pregnant. The book also explores the notion of medicine, and particularly hospitals, as a business trying to balance profits with the ethical demands of the medical profession.

About the Author

Since 2005, James Rutter has worked as a freelance journalist for print and Internet publications, including the “News of Delaware County,” “Main Line Times” and Broad Street Review. As a former chemist, college professor and competitive weightlifter, he writes about science, education and exercise. Rutter earned a B.A. in philosophy and biology from Albright College and studied philosophy and cognitive science at Temple University.

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